ROGER DAVID CUSHMAN P.A. NPI 1578742615

NPI Information

NPI: 1578742615
Provider Name: ROGER DAVID CUSHMAN, P.A.
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: BMH INC

PECOS Registration: Yes

Address:
2302 E. TERRY STREET
POCATELLO, ID
ZIP 83201
Phone: (208) 235-5910
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Roger David Cushman, P.A. is a medical physician assistant in Pocatello, ID with 17 years of experience. Roger David Cushman, P.A. NPI is 1578742615. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2302 E. TERRY STREET
POCATELLO, ID
ZIP 83201
Phone: (208) 235-5910

The NPI 1578742615 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/25/2007 and was last updated on 10/25/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	GPA-034	IDAHO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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